Aim of the Study: Cardioembolic stroke accounts for approximately 15-25% of ischemic strokes and is characterized by a poor prognosis. Atrial fibrillation (AF) is more commonly diagnosed in the elderly.The aim of the study was the assessment of the manifestations of AF in patients hospitalized due to cerebral stroke, with particular attention paid to newly diagnosed AF. Methods: A retrospective analysis was performed on 998 cerebral stroke patients. The data were analyzed for sex, age, cerebral stroke risk factors, drugs, NIHSS, RANKIN scores and ECG recordings on admission and at discharge. Results: The mean age of disease onset was 73 ± 16 years. Women accounted for 50.8% of patients. AF prior to hospital admission was diagnosed in 20.1% of patients, while de novo AF in 26.3% of patients during hospitalization. Hypercholesterolemia, hypertriglyceridemia and smoking were more commonly reported in ischemic stroke patients without AF compared to patients with ischemic stroke and AF. Ischemic heart disease, more frequent deaths, and a worse prognosis were more frequently observed in patients with ischemic stroke and AF compared to patients without AF. The first manifestation of AF in 25% of stroke patients was related to the period of the first 10 days of hospitalization. Discussion: The above data should prompt neurologists, cardiologists and family doctors to try to detect AF as a risk factor for ischemic stroke which worsens patient prognosis, prolongs hospital stay and contributes to increase in mortality, especially when more effective drug treatment is currently possible.
According to recent reports, malnutrition may be associated with a worse prognosis in stroke patients. The aim of this study was to determine the nutritional status of stroke patients and its impact on neurological and functional status of patients in the early post-stroke period. Our prospective study included a total of 128 patients admitted to the Stroke Unit. The assessment was made in the patients within the first week after the onset of stroke symptoms. Groups of patients with abnormal body mass index (BMI 25kg/m2) were compared to the group of normal BMI, serum albumin, total cholesterol, HDL and LDL levels were determined in each patient within 24h following admission. The analysis showed that the patients with lower levels of serum albumin and triglycerides had higher scores in the National Institutes of Health Stroke Scale (NIHSS) on admission. Patients with a higher risk of malnutrition, confirmed by the Subjective Global Assessment scale, had higher NIHSS scores. The study showed a positive relationship between the nutritional status and worse neurological status of patients in the early post-stroke period.Abbreviation: NIHSS; Rankin scale.
Type-2-diabetes mellitus (T2DM) is a global problem of medical, social and economic consequences. Physical activity is a vital therapy in patients with T2DM, but some of them cannot exercise for various reasons. The purpose of our pilot study was to determine whether a combination of neuromuscular electrostimulation (NMES) and insulin therapy could improve the management of T2DM patients with hemiplegia caused by an ischemic stroke. Fifteen immobile patients with T2DM on insulin therapy were enrolled in the study. NMES was applied to their lower limbs for 60 min, 5 days a week, over a period of 12 weeks. The intervention caused statistically significant reductions in the blood concentrations of glycated hemoglobin, total cholesterol and low-density cholesterol in the participants. Furthermore, systolic and diastolic blood pressure levels were significantly lower. More randomized clinical trials are needed to accurately measure the effect of NMES on T2DM treatment and to determine whether it can be an alternative for physical activity for immobile patients with T2DM.
13 August 2020 in Advances in Clinical and Experimental Medicine
So far, little is known about the properties of human epididymis protein 4 (HE4) in multiple sclerosis (MS). This type 4 glycoprotein belongs to a family of genes encoding proteins whose expression is associated with the process of spermatogenesis in the epididymis. The biological function of HE4 is not fully understood. Overexpression of HE4 has been found in several malignant tumors, particularly in ovarian cancer, as well as in mesothelioma, lung, endometrial, breast, and kidney cancers. To evaluate serum HE4 in patients with relapsing-remitting multiple sclerosis (RRMS) as compared to healthy controls. Fifty patients with RRMS undergoing first-line immunomodulatory treatment were enrolled in the prospective study. We analyzed correlations between serum HE4 levels and gender, age, disease duration, the Expanded Disability Status Scale (EDSS), annualized relapse rate (ARR), and magnetic resonance imaging (MRI) lesions. The patients from the study group had higher concentrations of HE4 than the subjects from the control group. Patients with EDSS > 2 had significantly higher concentrations of HE4. Positive correlations were found between HE4 concentrations and age as well as between HE4 concentrations and disease duration. No significant correlations were found between HE4 concentrations and EDSS or between HE4 concentrations and ARR. The results of the study indicate a novel aspect of the HE4 protein in the pathomechanisms of MS.
4 October 2023 in Annales Academiae Medicae Silesiensis
Wstęp: Zespół cieśni nadgarstka (ZCN) jest neuropatią kończyny górnej, pojawiającą się w wyniku ucisku nerwu pośrodkowego w kanale nadgarstka. Celem badania była ocena parametrów elektrofizjologicznych nerwu pośrodkowego przed leczeniem i 6 miesięcy po leczeniu operacyjnym ZCN u pacjentów obciążonych nikotynizmem oraz chorobami współistniejącymi.Materiał i metody: Do prospektywnego badania włączono 84 pacjentów z rozpoznanym klinicznie i elektrofizjologicznie ZCN kwalifikowanych do leczenia operacyjnego. U każdego pacjenta przed leczeniem oraz 6 miesięcy po leczeniu operacyjnym ZCN przeprowadzono badanie elektrofizjologiczne.Wyniki: Uzyskane wyniki dowodzą, że nikotynizm i cukrzyca istotnie pogarszają parametry elektrofizjologiczne u pacjentów poddanych leczeniu operacyjnemu ZCN.Wnioski: Nikotynizm i cukrzyca są niekorzystnymi rokowniczo czynnikami u osób operowanych z powodu ZCN.